Hi. I see posts on here from people struggling to get doctors to prescribe the treatment they need to control their RA but my situation is almost the opposite.
Background- diagnosed with sero positive RA in Feb 2016 aged 60 after sudden onset of severe joint pain and swelling. Xrays revealed damage to both knees and hand. Prescribed mtx (though never able to tolerate dose higher than 12.5mg - my current dose) and hydroxchloroquine (which was stopped a year ago due to possible eye damage). I also took oral steroids for the first few months.
My current DAS is 4.06, CRP 7.5 and ESR 14 mm.
I have very little pain or swelling day to day- just a bit of stiffness in the mornings in my hands and knees which I put down to the OA damage. Very rarely take painkillers.
At my routine consultant appointment in May the ‘new’ (to me) consultant was very keen to increase my medication. She did feel my joints and when I said they were not really hurting at all she said she thought I was ‘being brave’. I wasn’t!
After realising that it was probably not a good idea to up my mtx (even if by injection) due to my slightly raised liver results (which pre date diagnosis) she suggested adding in either sulfasalazine (consultant doesn’t favour this as much) Humira or baricitinib (olumiant).
She wrote this in letter to my GP - “my feeling is that she needs more aggressive treatment given her sero-positivity and the amount of synovitis I have seen today”
I have an appointment to see her again next Monday to tell her what I want to add.
I must admit that I am still not convinced that I need anything more but obviously am worried about further ‘silent’ damage to my joints.
My GP thinks I should go for the one that is an infusion as this may last longer between doses and , if (big if) I can then come off mtx and reduce the blood tests and monitoring I have at the moment ?(blood tests don’t bother me at all)GP also said that other drugs I’d been suggested were much more expensive than mtx so if the hospital were offering them to me ...........
I do worry about side effects and esp the further suppression of my immune system as I really don’t want lots of infections. Atm I am healthy so wonder if the increased risk is worth it.
On the other hand, I obviously don’t want to find years down the line that my joints have been seriously damaged because the RA had not been sufficiently controlled.
Any thoughts please? All comments welcome now you’ve had the patience to read this far.
Thanks.